A comparison of droperidol, metoclopramide and propofol in the prevention of postoperative nausea and vomiting

Abstract

Vomiting in the postoperative period is common in female patients undergoing gynaecologic laparoscopy. Thirty female outpatients ASA I II, aged 20-50 years scheduled for gynaecologic laparoscopy were enrolled in a randomized, double blind study to compare the efficacy and side effects of droperidol, metoclopramide and propofol administered in two doses during induction and at the first hour postoperatively. After induction with thiopental, anesthesia was maintained with 1% isoflurane in 70% N20 and 02. Vecuronium was administered for muscle relaxation and no opioid was used during, peri and postoperative period. Each patient was prospectively assigned at random to one of three

treatment groups: droperidol 40pgr/kg during

induction and 20pgr/kg at the first hour postoperatively, metoclopramide 0.30 mg/kg during induction and 0.15 mg/kg at the first hour postoperatively or propofol 10mg during induction and the first hour postoperatively. Mean arterial pressure, heart rate, nausea and vomiting and sedation scores were recorded at 30, 60, 90 minutes and 2, 4, 6, 12, 24 hours postoperatively. None of the patients had vomiting during 24 hours postoperatively and there was no significant difference between nausea and vomiting scores and hemodynamic parameters of three groups (p>0.05). Sedation scores were significantly higher during 6 hours postoperatively in droperidol group and during 1 hour in metoclopramide and propofol groups (p<0.05). We concluded that with this protocol; droperidol, metoclopramide and propofol were effective in preventing postoperative nausea and vomiting for outpatient gynaecologic laparoscopy however droperidol caused prolonged sedation.

Keywords

• Postoperative complication,Nausea,Vomiting,Sedation,Droperidol,Metoclopramide,Propofol

References

1. Watcha MF, White FF. Postoperative nausea and vomiting. Anesthesiology 1992;77:162-184.